'There are more Mid Staffs and I will find them'

Jeremy Hunt should be dead – politically speaking, at least. His entanglement
last year with Rupert Murdoch, BSkyB and the Leveson Inquiry was widely seen
at Westminster as fatal, a premature end to a once-promising career.

By James Kirkup, Political Editor

10:00PM BST 27 Sep 2013

Yet today Mr Hunt is the picture of vitality, both personally and politically. Cheery and upbeat, he appears energised by the monumental job of Health Secretary.

Like a lot of people who have near-death experiences, he seems to have come back from the brink bolder, embracing risk with a daring that borders on the reckless. Consider his plan to give the Care Quality Commission legal independence, legislating to give the health watchdog the same sort of freedom enjoyed by the Bank of England.

It will, he admits, mean more hospitals are revealed to be failing. After the exposure of scandalously poor care in Mid Staffs and Morecambe Bay, Mr Hunt put another 11 hospital trusts into “special measures” because they are failing.

The new regulatory regime will mean more such cases are exposed. “There are, amongst our brilliant hospitals, sadly some hospitals where failure has become very entrenched over very many years,” he says.

The only response is transparency: “We need a system where those problems surface quickly and where there’s no hiding place for politicians, no hiding place for NHS leaders.”

Willingness to highlight NHS failures has defined Mr Hunt’s year as Health Secretary. He has sought to recast the job not as ultimate manager but as chief scrutineer holding the service to account. Colleagues draw comparisons with Michael Gove, determined to put parents’ interests before those of the education establishment.

There is institutional logic to Mr Hunt’s approach too. The Coalition’s little-understood health reforms have effectively ended any role for ministers in NHS operations. Mr Hunt can still hear Aneurin Bevan’s dropped bedpan echoing in his Whitehall office. He just can’t do very much to ensure it gets picked up again. This is where Mr Hunt is running his biggest risk, betting that voters will thank him for exposing NHS failures instead of simply blaming him for them. That means a bumpy road to the 2015 election, he says. “My job as secretary of state is to find out where those failures are and do something about them, not to cover them up,” he says. “Labour says that identifying these problems is running down the NHS. I say the job of Health Secretary is to find out where the problems are … It will get worse before it gets better because the first thing you have to do is to have an honest system that actually tells people where the problems are and then you have to make sure that you are putting in place everything that it takes.”

The NHS is rarely far from the top of the political agenda, especially for Conservatives. Persuading voters that the health service was safe in Tory hands was – and is – at the heart of David Cameron’s strategy. For years that meant buckets of words about preserving the world’s best health service, and woe betide the Tory who dared whisper a word of criticism about it.

Yet consider Mr Hunt’s answer when asked if the NHS is the best health service in the world.

“It is the fairest health care system in the world and we have some of the highest standards in the world. At its best it is without question the best in the world but we have pockets of what happened at Mid Staffs and that’s what I have to sort out.”

After hospitals, Hunt’s reformation will move on. “We do need fundamental reform of primary care and that is going to be my big challenge for next year.”

That means GPs. Family doctors, we used to call them. But that was when we knew their names and they knew ours. Now they’re elusive, and extremely well-paid. Surely for an average partner’s salary of £103,000, they could open at weekends or evenings, or keep track of patients when they leave the surgery?

Mr Hunt’s boldness only goes so far. GPs are politically powerful, and he’s wary of criticising them. If they’re failing to meet patients’ needs, it’s not their fault, it’s their contract, a bureaucratic monster signed by Labour in 2004. He produces a copy of the document to demonstrate “micromanagement gone crazy”.

He will soon begin the tortuous negotiations for a new contract. GPs’ pay will remain generous – but only if care improves, he suggests.

A new regulatory regime will identify GPs who are “delivering the kind of service we need” – and those who are not. Steve Field, Mr Hunt’s Chief Inspector of General Practice, will assess 8,000 practices and grade them as outstanding, good, requiring improvement or inadequate.

Mr Hunt suggests that scrutiny will uncover the sort of failures in general practice revealed in hospitals. “I think we’ll find probably what there is in hospitals, that there is considerable variation.”

He draws a parallel with the education system. “Twenty years ago Ofsted was given permission to fail schools for the first time. There was initially great worry as people said, 'What’s happening, my local school’s been failed’.

Then people realised something could be done about it because the politicians and leaders in the system would be forced to turn around these failing schools and that is what is now happening in the NHS.”

Some Tories whisper that if Mr Hunt can survive health, he can survive anything – and could even be a leadership contender. He insists he lives day to day, never dreaming of greater things. “I’ve learned that you don’t think about the future, you just do the best you can, the job you’ve been given,” he says.

Yet he concludes with the caveat: “This is probably the biggest job I will ever do.” Probably.